K C Takarinda1, A D Harries2, S Srinath3, T Mutasa-Apollo1, C Sandy1, O Mugurungi1. 1. AIDS and TB Unit, Ministry of Health and Child Welfare, Harare, Zimbabwe. 2. International Union Against Tuberculosis and Lung Disease, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK. 3. International Union Against Tuberculosis and Lung Disease, South-East Asia Office, Delhi, India.
Abstract
SETTING: All public health facilities in Chitungwiza District, Zimbabwe. OBJECTIVE: To determine, in new tuberculosis (TB) patients registered in 2009, 1) the proportion of persons human immunodeficiency virus (HIV) tested, stratified by age, sex and type of TB, and 2) treatment outcomes in relation to type of TB and HIV status. DESIGN: Retrospective cohort study. RESULTS: Of 1800 TB patients, 1100 (61%) were tested, of whom 877 (80%) were HIV-positive and 75 (9%) were documented as receiving antiretroviral treatment (ART). HIV testing and HIV positivity were similar between patients with different types of TB. Overall, the treatment success rate was 70%, and 17% had transferred out. Being HIV-positive on ART was associated with better treatment success and lower transfer out; age ≥55 years was associated with poor treatment success and higher death rates. Defaulting was more common in those who did not undergo smear testing or in extra-pulmonary TB patients, while deaths were higher in males. CONCLUSION: In a Zimbabwe district, less than two thirds of TB patients were tested. Better treatment success was observed in patients documented as HIV-positive and on ART. Important lessons for improved TB control include increasing HIV testing uptake for better access to ART, more comprehensive recording practices on ART and better reporting on true outcomes of transfer-out patients.
SETTING: All public health facilities in Chitungwiza District, Zimbabwe. OBJECTIVE: To determine, in new tuberculosis (TB) patients registered in 2009, 1) the proportion of personshuman immunodeficiency virus (HIV) tested, stratified by age, sex and type of TB, and 2) treatment outcomes in relation to type of TB and HIV status. DESIGN: Retrospective cohort study. RESULTS: Of 1800 TB patients, 1100 (61%) were tested, of whom 877 (80%) were HIV-positive and 75 (9%) were documented as receiving antiretroviral treatment (ART). HIV testing and HIV positivity were similar between patients with different types of TB. Overall, the treatment success rate was 70%, and 17% had transferred out. Being HIV-positive on ART was associated with better treatment success and lower transfer out; age ≥55 years was associated with poor treatment success and higher death rates. Defaulting was more common in those who did not undergo smear testing or in extra-pulmonary TB patients, while deaths were higher in males. CONCLUSION: In a Zimbabwe district, less than two thirds of TB patients were tested. Better treatment success was observed in patients documented as HIV-positive and on ART. Important lessons for improved TB control include increasing HIV testing uptake for better access to ART, more comprehensive recording practices on ART and better reporting on true outcomes of transfer-out patients.
Entities:
Keywords:
HIV; Zimbabwe; new tuberculosis; treatment outcomes
Authors: S Meijnen; M M Weismuller; N J M Claessens; J H Kwanjana; F M Salaniponi; A D Harries Journal: Int J Tuberc Lung Dis Date: 2002-08 Impact factor: 2.373
Authors: Erik von Elm; Douglas G Altman; Matthias Egger; Stuart J Pocock; Peter C Gøtzsche; Jan P Vandenbroucke Journal: Lancet Date: 2007-10-20 Impact factor: 79.321
Authors: Anthony D Harries; Rony Zachariah; Elizabeth L Corbett; Stephen D Lawn; Ezio T Santos-Filho; Rhehab Chimzizi; Mark Harrington; Dermot Maher; Brian G Williams; Kevin M De Cock Journal: Lancet Date: 2010-05-18 Impact factor: 79.321
Authors: Simon Gregson; Elizabeth Gonese; Timothy B Hallett; Noah Taruberekera; John W Hargrove; Ben Lopman; Elizabeth L Corbett; Rob Dorrington; Sabada Dube; Karl Dehne; Owen Mugurungi Journal: Int J Epidemiol Date: 2010-04-20 Impact factor: 7.196
Authors: Elizabeth L Corbett; Catherine J Watt; Neff Walker; Dermot Maher; Brian G Williams; Mario C Raviglione; Christopher Dye Journal: Arch Intern Med Date: 2003-05-12
Authors: A M V Kumar; S Satyanarayana; S Dar Berger; S S Chadha; R J Singh; P Lal; J Tonsing; A D Harries Journal: Public Health Action Date: 2015-03-21
Authors: Kudakwashe C Takarinda; Anthony D Harries; Tsitsi Mutasa-Apollo; Charles Sandy; Owen Mugurungi Journal: BMC Public Health Date: 2012-11-15 Impact factor: 3.295
Authors: Jonathan Izudi; Daniel Semakula; Richard Sennono; Imelda K Tamwesigire; Francis Bajunirwe Journal: BMJ Open Date: 2019-09-06 Impact factor: 2.692